BOARD OF DIRECTORS WORKSHOP QUALITY & SAFETY …€¦ · Patient Safety Quality Improvement Act of...

Lee Memorial Health System Board of Directors

BOARD OF DIRECTORS WORKSHOP

QUALITY & SAFETY

Thursday, May 3, 2018 1:00 p.m.


BOARD OF DIRECTORS OFFICE

239-343-1500 FAX: 239-343-1599

13685 DOCTORS WAY #190 FT MYERS, FLORIDA 33912

CAPE CORAL HOSPITAL

GULF COAST MEDICAL CENTER

HEALTHPARK MEDICAL CENTER

LEE MEMORIAL HOSPITAL

GOLISANO CHILDRENS HOSPITAL OF SOUTHWEST FLORIDA

THE REHABILITATION HOSPITAL

LEE PHYSICIAN GROUP

LEE CONVENIENT CARE

BOARD OF DIRECTORS

DISTRICT ONE

Stephen R. Brown, M.D.

Therese Everly, BS, RRT

DISTRICT TWO

Donna Clarke

Nancy M. McGovern, RN, MSM

DISTRICT THREE

Sanford N. Cohen, M.D.

David Collins

DISTRICT FOUR

Diane Champion

Chris Hansen

DISTRICT FIVE

Jessica Carter Peer

Stephanie Meyer, BSN, RN

AGENDA

BOARD OF DIRECTORS WORKSHOP:

Quality & Safety

May 3, 2018 1:00 PM

Gulf Coast Medical Center – Boardroom (Medical Office Building) 13685 Doctors Way, Ft. Myers, FL 33912

CALL TO ORDER (Stephen Brown, M.D., Board Chairman) The Board of Lee Memorial Health System, doing business as Lee Health, Gulf Coast Medical Center & Lee Memorial Hospital/HealthPark Medical Center and the Board of Directors of its subsidiary corporations, including but not limited to Cape Memorial Hospital, Inc. doing business as Cape Coral Hospital; Lee Memorial Home Health, Inc.; and HealthPark Care Center, Inc.

WELCOME AND OPENING COMMENTS (Therese Everly, BS, RRT, Board Secretary)

1.

QUALITY AND SAFETY PLAYBOOK (Scott Nygaard, MD, MBA, Chief Operating and Medical Officer)

2. BALDRIGE (Scott Nygaard, MD, MBA, Chief Operating and Medical Officer)

3. CROSSWALK-STRATEGY, CMS AND TRUVEN (Scott Nygaard, MD, MBA, Chief Operating and Medical Officer)

4. STRATEGIC SCORECARD (Scott Nygaard, MD, MBA, Chief Operating and Medical Officer)

5.

CMS STAR CURRENT AND FUTURE PERFORMANCE (Scott Nygaard, MD, M.B.A., Chief Operating and Medical Officer) (Marilyn Kole, MD, M.B.A., Vice President, Clinical Transformation) (Alex Daneshmand, DO, M.B.A., Vice President Quality and Patient Safety) (Marcelo Zottolo, MS, System Director, Process Analytics)

6.

SAFETY UPDATE (Alex Daneshmand, DO, M.B.A., Vice President Quality and Patient Safety)

7.

DISCUSSION

8.

NEXT STEPS & CLOSING (Therese Everly, BS, RRT, Board Secretary)

9.

ADJOURN (Stephen Brown, M.D., Board Chairman)


WELCOME

(Therese Everly, BS, RRT, Board Secretary)

LEE HEALTH BOARD OF DIRECTORS

QUALITY WORKSHOPPresented by:Scott Nygaard, MD MBA

May 3, 2018

The disclosure of this document and the contents herein does not constitute a waiver of any and all protections afforded Patient Safety Work Product under the Patient Safety Quality Improvement Act of 2005 and implementing regulations.

Agenda

1. Quality and Safety Playbook

2. Baldrige

3. Crosswalk‐ Strategy, CMS and Truven

4. Strategic Scorecard

5. CMS Star Current and Future Performance

6. Safety Update

2

QUALITY AND SAFETY PLAYBOOKPresented by:Scott Nygaard, MD MBA

Why We Are Here Our Mission

To be a trusted partner, empowering healthier lives through care and compassion

Our Vision

To inspire hope and be a national leader for the advancement of health and healing

Our Values

Respect | Excellence | Compassion | Education

Our Strategic Priorities

Job 1: Improving Care for our Patients• We are not working BECAUSE of the scorekeepers (LeapFrog, CMS Star,

Truven Top 15 Health Systems, HCAHPS, CG‐CAHPS,etc):– JOB 1 to improve the quality of care, patient experience and value

we provide to our patients and community (Professional Promise)– The recognition is a result of OPERATIONAL EXCELLENCE– External validation is important (True North)– Celebrate our accomplishments

• Many different measurement systems, far in excess of what human being is capable of digesting

• Choosing what matters most ‐ “Fewer things done exceptionally well will make a bigger difference to those we serve.”

6

Rationale for Benchmarking

1. External benchmarks give us direction (Truven Top 15 Health Systems, LeapFrog, CMS Star, etc)

2. Data versus opinion:

• “Faced with the choice between changing one's mind and proving that there is no need to do so, almost everyone gets busy on the proof.”

John Kenneth Galbraith

7

TRUVEN Top 15 Health Systems Value• 25 year history dedicated to the development of objective measures of

leadership and evidence‐based management in healthcare

• Identifies those health system leadership teams that have most effectively aligned outstanding performance across the organization and achieved more reliable outcomes

• Honorees set the standards for excellence nationally

• Utilizes a balance scorecard approach including: Care Quality, Patient Safety, Use of Evidence‐Based Medicine, Patient Perception of Care and Operational Efficiency

8

TRUVEN Top 15 Health Systems Value

• Provides health system boards with critical insights into long‐term improvement

• Only objective, public data sources are used for calculating study metrics. Facilitates uniformity of definitions and data

• Statistical analysis by epidemiologists, statisticians, physicians and former hospital executives

9

Key Differences In 2017 Award Winners• Saved 66,000 more lives and caused 43,000 fewer patient complications

• Followed industry‐recommended standards of care more closely (97.3% versus 95.8%)

• Released patients from the hospital a half day sooner

• Readmitted patients less frequently and experienced fewer deaths within 30 days of admission

• Had nearly 18% shorter wait times in their emergency departments

• Had over 5% lower Medicare beneficiary cost per 30‐day episode of care

• Scored nearly 7 points higher on patient overall rating of care

• 79% of winners are health systems in the Top 100 Hospitals

10

2018 WinnersLarge Health Systems (total operating expense of more than $1.75 billion):

1. Mayo Foundation (Rochester, Minnesota)

2. Mercy (Chesterfield, Missouri)

3. Sentara Healthcare (Norfolk, Virginia)

4. St. Luke's Health System (Boise, Idaho)

5. UC Health (Aurora, Colorado)

11

Key Differences 2018 Award Winners• The key performance metrics that showed the most significant outperformance compared

to non‐winning peer group health systems include:

– Fewer in‐hospital deaths (14.6 percent)– Fewer complications and infections (17.3 percent and 16.2 percent,

respectively)– Shorter length of stay (0.4 days shorter)– Shorter emergency department wait times (40 minutes shorter per patient)– Lower spend (5.6 percent lower costs per episode, which includes combined

in‐hospital and post‐discharge costs)– Higher patient satisfaction, as measured by HCAHPS (2.3 percent higher)

12

Quality Program Approach“A good plan executed now is better than a perfect plan

executed next week.”General George S Patton

13

Improvement Opportunities

“The key to success is to employ a disciplined, strategic focus that balances all four quality domains and targets high‐impact, high‐value projects that will affect a large

portion of an organizations patient populations.”

John Byrnes, MD

14

7 Elements For Quality

1. Measurement

2. Clinical Quality Improvement

3. Patient Medication and Environmental Safety

4. Patient and Staff/Physician Satisfaction

5. Performance Improvement‐ LEAN

6. 100% Accreditation Readiness

7. Epidemiology and Infection Control

15

Measurement• Data Governance‐ the organizing framework for establishing strategy,

objectives and policies for corporate data.

• Data Stewardship‐ an ethic that embodies the responsible planning and management of resources.” In the realm of data management, data stewards are the keepers of the data throughout the organization.

• Data Management‐ is the set of functions designed to implement the policies created by data governance.

• Data Architecture‐ encompasses the conceptual, logical and physical models that define a data environment.

• Data Quality‐ includes standards and procedures on the quality of data and how it is monitored, cleansed and enriched. Traditional data quality includes standardization, address validation and geocoding, among other efforts.

16

Measurement• Data Administration‐ includes setting standards, policies and procedures

for managing day‐to‐day operations within the data architecture, including batch schedules and windows, monitoring procedures, notifications and archival/disposal.

• Data Security‐ includes policies and procedures to determine the level of access allowed for both source‐level data and analytics products within the organization.

• Data Life Cycle‐ data should be managed from the point it enters your organization until it is archived – or disposed of when it is no longer useful.

17

Clinical Quality Improvement

1. Year 1‐‐ Charter 10 QI teams (Clinical Consensus Groups)

2. Years 2‐5—Charter an additional 5 teams per year

3. Focus on the following opportunities• Reduce complications and mortality• Reduce readmissions and LOS• Reduce costs• Optimize P4P where appropriate• Truven Top 15 health systems where linked

18

Epidemiology and Infection Control

1. Reduce Hospital Acquired Infections:

• CAUTI, CLABSI, MRSA, C Diff, VAP and others

• Surgical Site Infections (SSI)

• Surveillance Data Base

19

Patient and Medication Safety1. High Reliability Organization‐ Safety Culture Transformation and Serious

Safety Events

2. Leapfrog Survey and Grade plus Agency for Healthcare Research and Quality Patient Safety Indicators (PSIs)

3. National Quality Forum

4. Institute for Safe Medical Practices (ISMP)

5. National Patient Safety Goals

6. Focus on the medication administration process

20

Board of Directors

“Improving the quality and safety of care in the United States is a public health emergency, and boards have a big

responsibility in that regard.”

David Nash, MD, MBA

21

You have a responsibility to have oversight for the quality of the organization.

THE BALDRIGE CRITERIA FOR PERFORMANCE EXCELLENCE: PROCESS TO RESULTS


W. Edwards Deming • Statistician who taught statistical process control to leaders in Japan after WWII

• By improving quality, companies will decrease expenses as well as increase productivity and market share– started the era of Total Quality Management

“If you do not know how to ask the right question, you discover nothing.”

23

Deming’s 14 Points

1. Create a constancy of purpose for improvement

2. Adopt the new philosophy

3. Cease dependence on inspections

4. End the practice of awarding business on price alone

5. Improve constantly and forever

6. Use training on the job

7. Institute training and retraining

24

Deming’s 14 Points8. Institute leadership

9. Drive out fear

10. Break down barriers between departments

11. Eliminate slogans and exhortations

12. Eliminate management by objectives

13. Remove barriers to pride of workmanship

14. Take action to accomplish the transformation

25

Excellence• Leapfrog Healthgroup Top Hospital

• Truven Health Top 15 Healthy System

• Governor’s Sterling Award (State)

• Baldrige Performance Excellence (National)

• Prevention of Harm is Discussed Openly

• Focus on Early Prevention

• Patient Experience at 90% of the Nation

• Financial Reward is an output of the culture

26

Malcom Baldrige Improvement Act Of 1987• Mid‐1980s, U.S. leaders realized that American companies

needed to focus on quality in order to compete in an ever‐expanding, demanding global market

• Secretary of Commerce Malcolm Baldrige was an advocate of quality management as a key to U.S. prosperity and sustainability

• Malcolm Baldrige National Quality Improvement Act of 1987 was to enhance the competitiveness of U.S. businesses

• Scope expanded to health care and education organizations in 1999

27

What Is Baldrige About?Improving organizational performance using an objective, evaluation…

• Accelerating improvement results

• Gaining an outside perspective

• Focusing on results that matter

• Energizing your workforce

• Learning from the feedback report

28

State Baldrige Programs

• The Florida Sterling Council is the sole provider of Florida’s Governor’s Sterling Award (GSA) endorsed by the Governor, the National Baldrige Program, and the State Alliance

• Organizations that aspire to the Baldrige Award must first become role models through their official state program

29

Baldrige Operating Model

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7 Areas of Focus: 1. Leadership

2. Strategic Planning

3. Customer‐focus

4. Measurement, Analysis and Knowledge

5. Workforce Planning

6. Operations Focus

7. Results

A Study by Truven Health analytics links hospitals that adopt and use Baldrige criteria to successful operations, management practices and overall performance

31

Baldrige Is a Holistic Management System

• A flexible “systems” approach ‐ non‐prescriptive

• Uses the latest validated management practices

• Supports many tools”

– ISO (International Organization for Standardization)

– Lean

– Balanced Scorecard

– Strategy Maps

32

33

2017

• Adventist Health Castle, Kailua Hawaii

• South Central Foundation, Anchorage, AK

Baldrige Healthcare Honorees 2017

Strategic Plan, Star Ratings and Watson Health Crosswalk

• Watson Health evaluates large, medium and small health systems

• Results correlate with the Baldrige Award winners¹.

35

1. “New Study Finds that Baldrige Award Recipient Hospitals Significantly Outperform Their Peers,” National Institute of Standards and Technology. October 25, 2011.

FYTD 18 STRATEGIC SCORECARD UPDATE

Presented by:Scott Nygaard, MD MBA


Exceptional Patient Experience

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Strategic Priority Key Performance IndicatorDesired

DirectionMeets Goal

Exceeds Goal

Current Status Tracking

Reporting Period

RIGHT CULTURE

76.8%Does not

MeetFYTD Feb74.0%Exceptional Patient

Experience

Patient Experience (Systemwide rollup of "Overall Rate" top box)

Higher is Better

74.1%

Right Care

39


DirectionMeets Goal

Exceeds Goal


Reporting Period

RIGHT CARE

16.9%Does not

Meet

Patient Impact(National Healthcare Safety Network nursing units, NHSN)

Excellent HealthOutcomes 15.5% 14.6%

Lower is Better

163 64 194

FYTD Jan

Does not Meet

12 mos ending Jan

2018

Medicare Payor 30-day Readmission Rate (Lee Health facilities only)

Lower is Better

Patient Impact by Condition

40


41

42


Coordinated Care Model

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* Next Gen ACO includes initial attribution of 25,311 lives, which may decline 10-15% due to loss of eligibility.


DirectionMeets Goal

Exceeds Goal


Reporting Period

RIGHT TIME & PLACE Increase the LPG Primary Care Patient Base

Higher is Better

10,500 12,600 9,901Does not

Meet

12 mos ending Feb

2018

Coordinated CareModel Covered Lives

Higher is Better

85,105 92,105Better

than Goal

As of February

2018*103,003

Right Cost

44


DirectionMeets Goal

Exceeds Goal


Reporting Period

RIGHT COST Year over year freestanding outpatient net revenue growth (2017 vs 2018)

Higher is Better

10.0% 12.0% 10.1%Meets Goal

FYTD Feb

Does Not Meet

FYTD Feb

Strong FinancialResults Operating Margin %

Higher is Better

4.5% 5.0% 4.1%


CMS 5 STAR RATING UPDATEPresented by:Scott Nygaard, MD, M.B.A., Chief Operating OfficerMarilyn Kole, MD, M.B.A., Vice President, Clinical TransformationAlex Daneshmand, DO, M.B.A., Vice President Quality and Patient SafetyMarcelo Zottolo, MS, System Director, Process Analytics

Strategic Plan, CMS Star And Truven

• Watson Health evaluates large, medium and small health systems

• Results correlate with the Baldrige Award winners¹.

48

1. “New Study Finds that Baldrige Award Recipient Hospitals Significantly Outperform Their Peers,” National Institute of Standards and Technology. October 25, 2011.

Glossary Terms • CAUTI‐ Catheter Associated Urinary Tract Infection

• CLABSI‐ Central Line Associated Blood Stream Infection

• PE/DVT‐ Pulmonary Embolus/Deep Vein Thrombosis

• Cdiff‐ Clostridium Difficile

• SSI COLO‐ Surgical Site Infection after Colorectal Surgery

• NHSN‐ National Healthcare Safety Network

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BOD – CMS 5 Star Dashboard

NOTE: These are the goals for each of the HAIs we setup at the beginning of the fiscal year and that the BOD and SEC approved. These are the only set of goals and align with operational goals and KPIs, patient impact and BOD 5 star dashboard. The percentiles vary by HAI because they depend on our performance during FY17.

Here is the parallel to stars:• 1 star = <20th percentile• 2 stars = 20th to 40th percentile• 3 stars = 40th to 60th percentile• 4 stars = 60th to 80th percentile• 5 stars = 80th percentile or higher

CAUTI‐ CMS 5 Star (Truven Top 15)

• FY18‐March performing better than the 80th percentile of the nation.

• Two consecutive months with no (NHSN) infections system‐wide

• Best performance in at least 18 months

• 77% reduction FY18‐Mar compared to FY15

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Key Points:

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CAUTI: Plans To Sustain 5 StarOngoing:

• Operational timeline for guideline Go live being set

• Nursing education for Go live‐ preparing for launch

• Decreasing utilization of devices in Operating Room ongoing

Completed:

• Evidenced based guidelines developed/approved through Medical Staff: Dec. 2017

• Epic Urinary culture order requirements Go live: December 2017

• Epic indications revised for insertion/continuation Go live: April 24th

• CAUTI prevention algorithm available to all staff: April 9th

• FY18‐March performing better than the 80th percentile of the nation.

• Three (NHSN) infections system‐wide FYTD


53

Key Points:

0.193

CLABSI: CMS 5‐Star (Truven Top 15)

CLABSI: Plans To Sustain 5 Star Ongoing: • Operational Go live for guidelines‐ Bundle 1: April 30th

• Audits to begin post go live• Post go live Team calls to initiate 2 weeks post go live

Completed:• Guidelines completed and Medical staff approved: Dec 2017• Epic indications revised for insertion/continuation Go live: April 24th

• Nursing education completed by April 30th

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CLABSI‐ Operational Plan

CDIFF: CMS 4 Star (Truven Top 15)

• FY18‐March performing at 4 stars (between 60th and 80th percentile of the nation.

• Not achieving goal set at 80th percentile or better


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Key Points:

CDIFF‐ Plans To Achieve 5 StarOngoing:

• Go live for guidelines: June/July 2018

• Antibiotic Stewardship Workgroup removing specific medications automatically listed on order sets

• Hand hygiene workgroup activated to help improve HAC’s

Completed:

• Guidelines completed and Medical Staff approved: March 2018

• Epic changes to educate providers about PCR testing

• Epic previous C diff results visible when C diff is ordered

• Epic hard stop to require 3 indications for any orders

• Calls to physicians/Advanced providers when repeat ordering is identified

• Decreased Levaquin use through Pharmacy and Antibiotic Stewardship

(PCR‐Polymerase chain reaction) 57

MRSA: CMS 3‐Star (Truven Top 15)

• FY18‐March performing at the national average (3 stars)

• 5 infections in Q1, 4 infections in Q2 system‐wide

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Key Points:

MRSA: Plans To Advance To 5 Star

Ongoing:

Infection Prevention has recommended the following Action Plan:

• Implement universal chlorhexidine gluconate (CHG) bathing

• Avoid routine transfers of MRSA infected patients

• Do blood cultures only when “clinically indicated”

59

SSI‐COLO: CMS 2 Star (Truven Top 15)

• FY18‐March performing at 2 stars

• 2 infections system‐wide in February


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Key Points:

SSI COLO: Plans To Advance RankOngoing:

• 1:1 meeting with surgeons initiated: February 2018

• Adding PSI and PE/DVT data to surgeon 1:1 meetings: April 2018

• Re‐designed coding review of cases and corrections in NHSN: April 2018

• Anesthesia education for ASA scoring/Use of ERAS protocols/ Glycemic control in OR

• Surgical Site Infection guidelines in process‐CCG presenting May 29th to PLC

• Data transparency PLC task force with IT data governance forming to engage physicians in data transparency to improve outcomes

Completed:

• Guidelines completed for standardization in Surgical Services

• SMSQC sent SSI information/education to Colorectal surgeons March 2018

• Redesigned Infection Prevention SSI determination with IP’s/CT/IP Directors/Surgeons review

• 1:1 meeting with surgeons to review infections: Dr.’s Abou‐Lahoud, Doan, Neale, Ravipati, All LPG surgeons, Kowalsky, Bloomston, Zolfoghary, Manibo

PSI‐Patient safety Indicators

PE/DVT‐ Pulmonary embolus/Deep vein thrombosis

PLC‐Physician Leadership Council

SMSQC‐System Medical Staff Quality Committee61

CMS PE/DVT: 4‐Star (Truven Top 15)

Key Points:• FY18‐February performing at 4 star level (above 60th percentile)

• Zero PE/DVTs in February, 11 PE/DVTs system wide

• 43% reduction from FY15

Ongoing: • PE/DVT workgroup starting April 2018• Pre billing case reviews process redesigned: April 2018• Initiating surgeon review of cases 1:1• Exploring opportunities with new Epic upgrade to 2018• Validation of data from Crimson to 3M required

Completed:• Chart reviews for cases from December 2017–current: completed• Pharmacy engaged in reviews to identify opportunities to trigger surgeons real time• Early identification of cases within 1 week of event through Coding versus 45 days

PE/DVT: Plans To Advance To 5 Star

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Readmissions: CMS 1 Star (Truven Top 15)

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Impact on Fiscal Year 2018 Readmission Rate

Projected Impact on FY 2019 If Full System Strategy Deployment by October 2018 14.08%

Projected Impact on FY 2018 PerformanceIf Project Pilots Initiate by May 2018

Readmissions Program TimelineApril May June July August September October November December

READMISSION RISK SCORE System Wide

PHARMACY MED TO BEDS LMH HPMC GCHSWF GCMS CCH

PHARMACIST MED RECONCILIATION Partial capacity system wide Full capacity system wide

MYCHART TELEMEDICINE VISIT LMH

COMPLEX CARE CENTER LMH GCHSWF

FOLLOW UP APPOINTMENTS All Moderate and High Risk Medicare Discharges

LEE HEALTH SAFETY PROGRAMPresented by:K. Alex Daneshmand, DO, MBA, FAAPVice President of Quality and Patient Safety Officer


Safety Journey at Lee Health

• Current: Where Are We?

• Future: What Does it Look Like?

• Action: How Do We Get There?

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Current Perception of Safety

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2017 Safety Perception from Agency for Healthcare Research and Quality

Current Safety Status: Where Are We?

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Current Safety Status: Where Are We?

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All Harm Can Be Prevented22% Safety and 22% Mortality

Current State: Leapfrog Hospital Grades

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Future Safety: What Does It Look Like?

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In Becoming a Highly Reliable Organization


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Becoming a Highly Reliable Organization

1. Preoccupation with Failure:Regarding small, inconsequential errors as a symptom that something is wrong; finding the event early regardless how small they are

2. Sensitive to Operations:Paying attention to what’s happening on the front‐line

3. Reluctance to Simplify:Encourage diversity in experience, perspective, and opinion

4. Commitment to Resilience:Developing capabilities to detect, contain, and bounce‐back from events that do occur

5. Deference to Expertise:Pushing decision making down and around to the person with the most related knowledge and expertise


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In Becoming a Highly Reliable Organization1. Preoccupation with Failure:

• Increasing Good Catches in the System• Prevention at the front‐line

2. Sensitive to Operations:• Early intervention Signals (Sepsis and Patients at risk)• Detection of unsafe behaviors

3. Reluctance to Simplify:• Listening to learn and prevent• Create processes that are easy to do


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In Becoming a Highly Reliable Organization

4. Commitment to Resilience:• Create systems that are interconnected and

have a check and audit system• Bring Alignment to Safety under the same

umbrella

5. Deference to Expertise:• Use experts in building this system at the

ground level• Let the ground level build what works best for

them and provide them expert support

Patient Safety

Environmental Safety

Employee Safety Security

Action: How Do We Get There?

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Pathological SystemWe pay attention as long as we don’t get in trouble

Reactive SystemSafety is important and we evaluate every major safety event

Calculative SystemWe have systems in place to manage all hazards

Proactive SystemSafety values is addressed by leadership and drives continuous

improvement

Predictive SystemThis is how we prevent the next safety eventThat is how we do business around here

Modified from Prof. Patrick Hudson, Univ. Leiden

Action: How Do We Get There?

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• Building trust through transparency• Set up accountability for leaders that require closing the loop of communication on safety issues

• Create an Environment for Ownership to Excel• Align our safety goals around “excellence in care” • Make safety personal to all of our employees and patients• Partner with patients and their families in keeping them safe• Create early detection system• Trust and support our front line system in building processes that place redundancy in keeping patient safe

• Set up the bar higher on our safety expectation and reporting safety events

Scope BroadeningProfessional safety includes:

• Industrial hygiene and toxicology

• Design of engineering hazard controls, fire protection, ergonomics

• System and process safety

• Safety and health program management, accident investigation and analysis

• Product safety, construction safety, education and training methods

• Measurement of safety performance, human behavior, environmental safety and health

• Safety, health and environmental laws, regulations and standards.

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Patient’s Safety Story

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APPENDIX


Discussion


NEXT STEPS & CLOSING (Therese Everly, BS, RRT, Board Secretary)

ADJOURNMENT

DATE OF THE NEXT REGULARLY SCHEDULED

MEETING

PLANNING BOARD, TRAUMA DISTRICT AND FULL BOARD OF

DIRECTORS

THURSDAY, MAY 17, 2018

1:00 P.M.

Gulf Coast Medical Center- Boardroom Medical Office Building

13685 Doctors Way Ft. Myers, FL 33912

BOARD OF DIRECTORS WORKSHOP QUALITY & SAFETY …€¦ · Patient Safety Quality Improvement Act of...

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